Ömer TAŞBULAK, Ahmet Anıl ŞAHİN, Serkan KAHRAMAN

Impact of cardiac rehabilitation on ventricular repolarization indices following coronary artery bypass grafting

Background: The aim of this study was to evaluate the effect of cardiac rehabilitation on electrocardiographic changes in patients undergoing isolated coronary artery bypass grafting. Methods: Between January 2016 and July 2019, a total of 625 patients (485 males, 140 females; mean age: 59.6 years; range, 50.6 to 68.6 years) who underwent isolated coronary artery bypass grafting and survived were retrospectively analyzed. The patients were divided into two groups according to the participation in the cardiac rehabilitation program as follows: the Rehab(+) group (n=363) and the Rehab(-) group (n=262). Electrocardiographic parameters of both groups were compared. Results: There was a significant decrease in the electrocardiographic findings of heart rate (p

Kardiyak rehabilitasyonun koroner arter baypas greftleme sonrası ventriküler repolarizasyon indekslerine etkisi

Amaç: Bu çalışmada, izole koroner arter baypas greftleme yapılan hastalarda kardiyak rehabilitasyonun elektrokardiyografik değişiklikler üzerindeki etkisi değerlendirildi. Çalışma planı: Ocak 2016-Temmuz 2019 tarihleri arasında, izole koroner arter baypas greftleme yapılan ve sağ kalan toplam 6 25 h asta ( 485 e rkek, 1 40 k adın; o rt. y aş: 5 9.6 y ıl; dağılım, 50.6-68.6 yıl) retrospektif olarak incelendi. Hastalar kardiyak rehabilitasyon programına katılım durumlarına göre Rehab(+) (n=363) ve Rehab(-) (n=262) olmak üzere iki gruba ayrıldı. Her iki grubun elektrokardiyografik parametreleri karşılaştırıldı. Bulgular: Ameliyat öncesi ve sonrasında Rehab(+) grubunun elektrokardiyografisinde kalp hızı (p

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1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018;39:3021-104.
2. Beauchamp A, Worcester M, Ng A, Murphy B, Tatoulis J, Grigg L, et al. Attendance at cardiac rehabilitation is associated with lower all-cause mortality after 14 years of follow-up. Heart 2013;99:620-5.
3. McMahon SR, Ades PA, Thompson PD. The role of cardiac rehabilitation in patients with heart disease. Trends Cardiovasc Med 2017;27:420-5.
4. Malfatto G, Facchini M, Bragato R, Branzi G, Sala L, Leonetti G. Short and long term effects of exercise training on the tonic autonomic modulation of heart rate variability after myocardial infarction. Eur Heart J 1996;17:532-8.
5. O’Connor GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS Jr, et al. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 1989;80:234-44.
6. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009;360:961-72.
7. Rubin DA, Nieminski KE, Monteferrante JC, Magee T, Reed GE, Herman MV. Ventricular arrhythmias after coronary artery bypass graft surgery: Incidence, risk factors and longterm prognosis. J Am Coll Cardiol 1985;6:307-10.
8. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-80.
9. Smetana P, Schmidt A, Zabel M, Hnatkova K, Franz M, Huber K, et al. Assessment of repolarization heterogeneity for prediction of mortality in cardiovascular disease: Peak to the end of the T wave interval and nondipolar repolarization components. J Electrocardiol 2011;44:301-8.
10. Goldenberg I, Moss AJ, Zareba W. QT interval: How to measure it and what is “normal”. J Cardiovasc Electrophysiol 2006;17:333-6.
11. Higham PD, Furniss SS, Campbell RW. QT dispersion and components of the QT interval in ischaemia and infarction. Br Heart J 1995;73:32-6.
12. Kors JA, Ritsema van Eck HJ, van Herpen G. The meaning of the Tp-Te interval and its diagnostic value. J Electrocardiol 2008;41:575-80.
13. Aydinlar A, Sentürk T, Ozdemïr B, Kaderli AA, Aydin O. Effect of percutaneous transluminal coronary angioplasty on QT dispersion and heart rate variability parameters. Cardiovasc J Afr 2009;20:240-4.
14. Aytemir K, Yap YG, Ozmen F. Effect of acute ischemia on QT dispersion. Am Heart J 1999;138:385-6.
15. Jiménez-Candil J, González IC, González Matas JM, Albarrán C, Pabón P, Moríñigo JL, et al. Short- and longterm prognostic value of the corrected QT interval in the non-ST-elevation acute coronary syndrome. J Electrocardiol 2007;40:180-7.
16. Papadopoulos CE, Zaglavara T, Karvounis HI, Haaverstad R, Parharidis GE, Louridas GE, et al. QT dispersion is determined by the relative extent of normal, hibernating, and scarred myocardium in patients with chronic ischemic cardiomyopathy. A dobutamine stress echocardiography study before and after surgical revascularization. J Electrocardiol 2006;39:103-9.
17. Cagli K, Ozbakir C, Ergun K, Bakuy V, Circi R, Circi P. Electrocardiographic changes after coronary artery surgery. Asian Cardiovasc Thorac Ann 2006;14:294-9.
18. Gulcan O, Sezgin AT, Demircan S, Atalay H, Turkoz R. Effect of coronary artery bypass grafting and aneurysmectomy on QT dispersion in moderate or severe left ventricular dysfunction. Am Heart J 2005;149:917-20.
19. Kalapura T, Lavie CJ, Jaffrani W, Chilakamarri V, Milani RV. Effects of cardiac rehabilitation and exercise training on indexes of dispersion of ventricular repolarization in patients after acute myocardial infarction. Am J Cardiol 2003;92:292-4.
20. Ali A, Mehra MR, Malik FS, Lavie CJ, Bass D, Milani RV. Effects of aerobic exercise training on indices of ventricular repolarization in patients with chronic heart failure. Chest 1999;116:83-7.
21. Gambassi BB, Almeida FJF, Almeida AEAF, Ribeiro DAF, Gomes RSA, Chaves LFC, et al. Acute response to aerobic exercise on autonomic cardiac control of patients in phase III of a cardiovascular rehabilitation program following coronary artery bypass grafting. Braz J Cardiovasc Surg 2019;34:305-10.
22. Vasheghani-Farahani A, Asef-Kabiri L, Masoudkabir F, Davoodi G, Nejatian M, Saadat S, et al. Effect of exercisebased cardiac rehabilitation following coronary artery bypass surgery on ventricular repolarization indices. J Cardiopulm Rehabil Prev 2011;31:239-44.
23. Nishi I, Sugiyama A, Takahara A, Kuroki K, Igawa M, Enomoto T, et al. Utility of short-term variability of repolarization as a marker for monitoring a safe exercise training program in patients with cardiac diseases. Int Heart J 2011;52:304-7.
24. Cerşit S, Cerşit HP. Impact of cardiac rehabilitation on ventricular repolarization indexes in patients with rheumatid arthritis. J Electrocardiol 2018;51:787-91.